General Guidelines Research Articles

Qualitative interviews for hospitalists addressing lung cancer screening

Novel strategies are needed to improve low rates of lung cancer screening (LCS) in the US. Seeking to determine hospitalists’ perspectives on leveraging hospitalizations to identify patients eligible for LCS, we performed qualitative interviews with eight hospitalists from two hospitals within a large integrated healthcare system. The interviews used semi-structured questions to assess (1) knowledge and practice of general screening and LCS guidelines from the United States Preventive Services Task Force (USPSTF), (2) identification of smoking history, and (3) hospitalists’ views on how data obtained during hospitalization may be utilized to improve general screening and LCS post hospitalization. We ultimately reached the conclusion that hospitalists would support a dedicated program to identify hospitalized patients eligible for LCS and facilitate testing after discharge. Efforts to identify patients and arrange subsequent screening should be performed by team members outside the inpatient team.

Redefining Neural Architecture Search of Heterogeneous Multinetwork Models by Characterizing Variation Operators and Model Components.

With neural architecture search (NAS) methods gaining ground on manually designed deep neural networks-even more rapidly as model sophistication escalates-the research trend is shifting toward arranging different and often increasingly complex NAS spaces. In this conjuncture, delineating algorithms which can efficiently explore these search spaces can result in a significant improvement over currently used methods, which, in general, randomly select the structural variation operator, hoping for a performance gain. In this article, we investigate the effect of different variation operators in a complex domain, that of multinetwork heterogeneous neural models. These models have an extensive and complex search space of structures as they require multiple subnetworks within the general model in order to answer different output types. From that investigation, we extract a set of general guidelines whose application is not limited to that particular type of model and are useful to determine the direction in which an architecture optimization method could find the largest improvement. To deduce the set of guidelines, we characterize both the variation operators, according to their effect on the complexity and performance of the model; and the models, relying on diverse metrics which estimate the quality of the different parts composing it.

When enough is enough: Optimising monitoring effort for large-scale wolf population size estimation in the Italian Alps.

The ongoing expansion of wolf (Canis lupus) populations in Europe has led to a growing demand for up-to-date abundance estimates. Non-invasive genetic sampling (NGS) is now widely used to monitor wolves, as it allows individual identification and abundance estimation without physically capturing individuals. However, NGS is resource-intensive, partly due to the elusive behaviour and wide distribution of wolves, as well as the cost of DNA analyses. Optimisation of sampling strategies is therefore a requirement for the long-term sustainability of wolf monitoring programs. Using data from the 2020-2021 Italian Alpine wolf monitoring, we investigate how (i) reducing the number of samples genotyped, (ii) reducing the number of transects, and (iii) reducing the number of repetitions of each search transect impacted spatial capture-recapture population size estimates. Our study revealed that a 25% reduction in the number of transects or, alternatively, a 50% reduction in the maximum number of repetitions yielded abundance estimates comparable to those obtained using the entire dataset. These modifications would result in a 2046 km reduction in total transect length and 19,628 km reduction in total distance searched. Further reducing the number of transects resulted in up to 15% lower and up to 17% less precise abundance estimates. Reducing only the number of genotyped samples led to higher (5%) and less precise (20%) abundance estimates. Randomly subsampling genotyped samples reduced the number of detections per individual, whereas subsampling search transects resulted in a less pronounced decrease in both the total number of detections and individuals detected. Our work shows how it is possible to optimise wolf monitoring by reducing search effort while maintaining the quality of abundance estimates, by adopting a modelling framework that uses a first survey dataset. We further provide general guidelines on how to optimise sampling effort when using spatial capture-recapture in large-scale monitoring programmes.

УДОСКОНАЛЕННЯ КУЛЬТУРНО-ЕТИЧНИХ ЗАСАД УПРАВЛІНСЬКИХ ВІДНОСИН У ПУБЛІЧНОМУ УПРАВЛІННІ

The article reveals the basics of the cultural and ethical foundations of managerial relations in public administration, describes the culture of managerial relations in the public administration system elucidates the basic foundations of the ethical foundations of managerial relations in the public administration system. It is noted that the European integration progress of Ukraine requires the formation of a new generation of employees who would act in accordance with European standards of management, moral and ethical norms of European society, correspond to modern trends in the political, economic arena, social realities and be able to observe a fundamentally new order of organizational and management interactions. The specifics of compliance with ethical and moral principles and the main components of the management culture of civil servants are determined: ethical beliefs, moral qualities (sense of responsibility, conscience, uncompromisingness), moral habits, abilities and actions, etc. The general characteristics of the culture of the social environment in which the personality of the civil servant is formed and the culture of the society in which his official activity is carried out are revealed, which determine the content of value orientation in the process of performing professional duties and general moral guidelines. It has been established that the key point for building professional ethics is awareness of the purpose of the profession in society, the social functions that professionals must perform – awareness of the mission of the profession. Such a mission for civil servants is the principle of service to the people – the semantic core around which the system of cultural and ethical professional value orientations of public managers should be built. Directions for improving the cultural and ethical foundations of managerial relations in public administration at the organizational and personal levels are proposed.

Optimizing avian translocation success: A systematic review of the effect of release age on survival, dispersal, and productivity

AbstractThe success of avian translocations depends on many factors. Release age is often cited as an influential factor that warrants further study, yet no general guidelines exist to improve the outcome of translocations. We conducted a systematic review of literature on captive‐reared or wild‐caught birds that incorporated >1 age class in their analyses of post‐release survival, dispersal, or reproduction. Fifty‐two studies met our search criteria, and 39 were retained for an evaluation of post‐release survival. For studies reporting at least one trend, more reported higher post‐release survival when birds were translocated at younger ages (68%) than at older ages (32%). This pattern was most pronounced for wild‐caught birds and for captive‐reared birds released within their first year of life. Captive‐reared birds of prey were an exception, with birds released at older ages often having higher survival than birds released at younger ages. We review the authors' hypotheses for why birds released at younger ages are more likely to settle, survive, and breed. More research is needed on the potential effects of release age on dispersal and reproduction. We recommend that future studies incorporate age of release as a covariate and control for the effect of season of release in experiments.

A Review of Factors for Successful Childbirth and Return to Sport for Female Elite Athletes

An increasing number of elite athletes who experience pregnancy and childbirth during their careers and subsequently return to competitive sports is steadily increasing. While general guidelines for physical activity during and after pregnancy exist for the nonathletes and recreational athletes, there is a lack of evidence-based guidelines for high level competitive athletes. As a result, athletes often return to training without adequate support, and some may even choose to give up pregnancy and parenthood. This review aims to examine the factors that influence the healthy pregnancy and successful return to elite sport among female athletes, based on the experiences of those who have navigated this transition successfully and the research in this area. The studies included in this review emphasize the need for an inclusive sports environment, open and supportive systems, and institutional changes and academic research to enable informed decision-making for pregnant and parenting elite athletes. To ensure sufficient recovery time for elite athletes after childbirth and to develop evidence-based return-to-sport programs, as well as provide clear policies and practices for financial and social support, including childcare, collaboration and support from national governments, sports organizations, and associations is crucial.

Knowledge and Practices of Nurses on Preoperative Fasting Guidelines Care for Adult Patients: A Review

Preoperative fasting is the term used to describe the time before a surgical procedure during which patients are not permitted to consume any liquids or solids by mouth. Pre-operative fasting guidelines for adult patients are critical for ensuring the well-being and safety of surgical patients. Pre-operative fasting is a standard practice designed to reduce the risk of complications during surgery, such as gastric aspiration. Fasting helps to prevent complications like pulmonary aspiration pneumonia, which can occur if patients do not empty their stomachs before surgery. Fasting durations for solids, liquids, and clear fluids are typically recommended in guidelines. Fasting before surgery or medical procedures that require anesthesia is a common practice. Fasting is done to reduce the risk of aspiration, which occurs when stomach contents enter the lungs during anesthesia and can lead to serious complications. The general guidelines for preoperative fasting typically include avoiding solid food for a specific period before the procedure, as well as limiting liquid intake. Fasting durations and recommendations, on the other hand, can vary. There has been some evolution in preoperative fasting guidelines in recent years. The traditional method involved fasting for extended periods, sometimes up to 12 hours or more for solid food and 2-6 hours for clear liquids. Recent research and updated guidelines in various countries suggest that shorter fasting periods may be just as effective in preventing aspiration while also improving hydration and reducing the stress associated with prolonged fasting. Many healthcare facilities are now more relaxed about preoperative fasting, allowing clear liquids up to 2 hours before surgery and light meals up to 6 hours before the procedure. It is important to note, however, that these guidelines are subject to change, specific fasting instructions are dependent on factors such as the type of surgery, the patient's health status, and .....

Factors Controlling Cage Escape Yields of Closed- and Open-Shell Metal Complexes in Bimolecular Photoinduced Electron Transfer.

The cage escape yield, i.e., the separation of the geminate radical pair formed immediately after bimolecular excited-state electron transfer, was studied in 11 solvents using six Fe(III), Ru(II), and Ir(III) photosensitizers and tri-p-tolylamine as the electron donor. Among all complexes, the largest cage escape yields (0.67-1) were recorded for the Ir(III) photosensitizer, showing the highest potential as a photocatalyst in photoredox catalysis. These yields dropped to values around 0.65 for both Ru(II) photosensitizers and to values around 0.38 for the Os(II) photosensitizer. Interestingly, for both open-shell Fe(III) complexes, the yields were small (<0.1) in solvents with dielectric constant greater than 20 but were shown to reach values up to 0.58 in solvents with low dielectric constants. The results presented herein on closed-shell photosensitizers suggest that the low rate of triplet-singlet intersystem crossing within the manifold of states of the geminate radical pair implies that charge recombination toward the ground state is a spin-forbidden process, favoring large cage escape yields that are not influenced by dielectric effects. Geminate charge recombination in open-shell metal complexes, such as the two Fe(III) photosensitizers studied herein, is no longer a spin-forbidden process and becomes highly sensitive to solvent effects. Altogether, this study provides general guidelines for factors influencing bimolecular excited-state reactivity using prototypical photosensitizers but also allows one to foresee a great development of Fe(III) photosensitizers with the 2LMCT excited state in photoredox catalysis, providing that solvents with low dielectric constants are used.

Modern approaches for evaluating treatment effect heterogeneity from clinical trials and observational data.

In this paper, we review recent advances in statistical methods for the evaluation of the heterogeneity of treatment effects (HTE), including subgroup identification and estimation of individualized treatment regimens, from randomized clinical trials and observational studies. We identify several types of approaches using the features introduced in Lipkovich et al (Stat Med 2017;36: 136-196) that distinguish the recommended principled methods from basic methods for HTE evaluation that typically rely on rules of thumb and general guidelines (the methods are often referred to as common practices). We discuss the advantages and disadvantages of various principled methods as well as common measures for evaluating their performance. We use simulated data and a case study based on a historical clinical trial to illustrate several new approaches to HTE evaluation.

The Legality of Diplomas as Debt Guarantee in Civil Law (Case Study of RY Pawning His Friend's Two Diplomas)

A diploma is a graduation document of a student or student who has completed his or her study program. In this case, a diploma is a service because its value does not lie in its physical form, but in the meaning and function it has, namely proof that a person has successfully completed a certain educational program. However, in several guarantee institutions spread across Indonesia, there are still many who allow diplomas as an object of guarantee. In fact, the guarantee law is a closed law to protect the parties involved and is also a general guideline so that it cannot be arbitrarily modified. The closure of the guarantee law for the parties involved raises the question of whether the diploma as a guarantee means modifying the guarantee law that has been set by the state. Therefore, the author wants to examine the legality of a diploma as collateral for debt in civil law in order to find out whether the diploma already has a basis in civil law as a guarantee and how to process how to settle in case of default by the debtor who gives the diploma to be detained.

A simple predictive three-step chemical model for gaseous stoichiometric hydrogen–oxygen detonation quenching

Two types of three-step chain-branching kinetics for gaseous hydrogen–oxygen detonation quenching are proposed. The reaction rates dependency on density and pressure, as well as the change in molecular weight are included and fitted to results of detailed chemistry not only along the Hugoniot curve but also behind transverse waves. The trend of induction and reaction times and reduced activation energy of zero-dimensional constant pressure combustion process as well as the induction, reaction lengths, and peak thermicity of the ZND model are focused on in the calibration procedure. One model (3SM-I) is designed to model the ideal detonation whereas the other (3SM-N) focuses on the Dn−κ curve during calibration, i.e. the detonation velocity-mean front curvature curves, aiming to capture the non-idealities. The predictive ability using the proposed models is evaluated in a detonation transmission configuration, a layer of ▪ mixture being confined by N2, in determining the critical height, reactive layer height at which detonation transmission is not possible. Both approaches get closer to the critical height from detailed chemistry. With the present set of model parameters, 3SM-I is better than 3SM-N for prediction of critical height. Moreover, borrowing analytical ignition criteria and wave hierarchy approach, the comparison of various chemical models that are able to recover the critical height suggests that the slope of the Dn−κ curve, linked with the chemical response to losses, is the first key parameter for the critical height determination. In addition, the dynamics of the extinction near criticality such as appearance of transverse detonation and quenching distance from 3SM-I are in very good agreement with that of detailed chemistry due to better estimation of the chemical features along the Hugoniot curve and behind transverse waves. The present study provides a guideline to get simplified chemical models from detailed chemistry for predictive simulations.Novelty and significance statementThe novelty of research is two-fold. The first is to provide general guideline to get simplified models from detailed chemistry for the simulation of detonation extinction with improved predictive ability. The tested configuration was that of a stoichiometric hydrogen–oxygen mixture semi-confined by nitrogen. The evolution of the induction, reaction times, and the maximum thermicity were used as fitting targets for our 3-step model. Furthermore, they were evaluated not only at the post-shock states along the Hugoniot curve, but also behind the transverse waves, keystones of the cellular structure. Second, borrowing analytical ignition criteria and wave hierarchy approach, the comparison of different chemical models that were able to recover the critical height suggested that the slope of the normal velocity–curvature curve was the first key parameter for the critical height determination. Moreover, the dynamics of extinction near criticality, and quenching distance depended on the reaction rate dependency on density and pressure.

A comparative study of early childhood education and care national documents between China and Finland

Early childhood education and care (ECEC) serves as a crucial foundation for children’s holistic growth and lifelong learning. Despite its significance, comparative analyses of leading ECEC documents across cultures remain limited. To address this gap, our study conducts a comparative analysis to identify key aspects and examine similarities and differences in national ECEC documents from China and Finland. Methodologically, we used a triangle of researchers from China and Finland. We employed qualitative content analysis to systematically identify, examine, and compare the key aspects in these two countries from the leading ECEC documents, i.e., the Chinese national ECEC guidelines and the Finnish ECEC national core curriculum. The findings reveal numerous similarities alongside notable differences. Both countries place a high value on ECEC, emphasizing principles that shape the learning environment and use diverse pedagogical methods. However, nuanced variations exist in the approaches. The Chinese documents feature more specific guidelines tailored to different age groups, accompanied by detailed pedagogical suggestions, while the Finnish national core curriculum offers general guidelines for all preschool age groups, complemented by the unique feature of individual development plans for each child. The findings have significant implications for policymakers, ECEC educators, and practitioners in international contexts. Future studies are needed to further explore the specific pedagogies in ECEC between these two nations and to analyze how the curriculum and educational guidelines are implemented in pedagogical practices.

Diagnosis and management of peripartum cardiomyopathy and recurrence risk

Peripartum cardiomyopathy (PPCM) is a rare, but serious condition, with a non-negligible risk of adverse events. Several risk factors for PPCM have been individuated over the years, including Afro-American ethnicity, preeclampsia, advanced maternal age, genetic predisposition, multiparity, twin pregnancy, obesity, smoking and diabetes. However, PPCM pathophysiology is still poorly understood, thus making it challenging to develop disease specific therapies. At present, Bromocriptine is the only targeted drug, but further evidence is needed to establish indication and timing of administration. Therefore, these patients are mainly treated following general heart failure guidelines. Even though in most patients left ventricular ejection fraction recovers during follow-up, cases of persistent left ventricular dysfunction are not uncommon. Moreover, all patients detain a certain risk of recurrence after subsequent pregnancies, which is difficult to estimate due to the dearth of long-term prospective data.In this manuscript, we aim to provide an updated review of current evidence about PPCM pathophysiology, diagnosis, treatment and recurrence risk. In addition, we discuss the gaps in knowledge that should be addressed by future research.

Blood Flow Restriction Exercise as a Novel Conservative Standard in Patients with Knee Osteoarthritis—A Narrative Review

Knee osteoarthritis is a prevalent joint disease affecting millions of individuals globally. While total knee arthroplasty is an effective treatment for advanced stages of KOA, it may not be suitable for earlier stages or younger patients. Supervised exercise therapy has proven to be the first-line treatment of preference in tackling pain and disability caused by KOA. However, the high intensities required to induce positive muscle adaptations are not indicated in this population, as this is often accompanied by pain, discomfort, and frustration, leaving low-load resistance training as the only feasible method of treatment. Recently, the use of blood flow restriction training has begun to emerge as a substitute for high-load resistance training. With BFRT, a cuff is applied around the proximal aspect of the affected limb, causing partial arterial and full venous occlusion, thereby inducing localized hypoxia and the accumulation of metabolites, mimicking the effects of high-load resistance training, albeit with low loads. Consequently, BFRT might offer a suitable and more effective alternative for KOA patients who are not (yet) eligible for TKA compared to traditional exercise therapy. This review aims to summarize the current evidence as regards the application of Blood Flow Restriction in exercise therapy for knee osteoarthritis patients, with particular consideration of the underlying mechanisms and its safety, as well as general guidelines for practical implementation in clinical practice. In doing so, this narrative review aims to create a framework for translating from theory into practice.

Periodontal management during orthodontic-surgical treatment of maxillary impacted incisors: Acase report

The treatment of impacted teeth is a multidisciplinary process requiring close collaboration between periodontics and orthodontics. Impaction can have several causes, including physical obstructions in the eruption pathway, arch length discrepancies, or dental deformity. The management of these cases lies in the diagnosis established after an appropriate clinical and radiological examination. The age, position, etiology, and amount of space in the dental arch of an unerupted tooth determine how it should be treated. In several cases, orthodontic creating space, removing physical obstructions, and exposing the patient surgically with or without traction are general guidelines for treatment. In addition, ensuring adequate access to the tooth and the possibility of attaching an orthodontic anchor, the periodontal plastic surgery procedures associated with surgical clearance must preserve the integrity of the periodontium of the impacted tooth, as well as that of adjacent teeth, and above all promote the long-term maintenance of their periodontal health.

Translations and Adaptations of Assessment Tools in Early Childhood Education: A Scoping Review

Objective: This scoping review sought to provide an insight into the key processes used in the translation and adaptation of assessment tools in peer-reviewed literature on assessment tools in early childhood education. Methods: Peer-reviewed articles published between 2012 and 2022 were identified via independent systematic searches using the databases Academic Search Complete, ERIC, Education Source, and APA PsycInfo. The articles included in this scoping were coded using a data extraction form developed for specifically for this study. Results: In the 56 articles selected, 33 reported forward translation; the analyses and findings of this scoping review were based on these 33. 30% of the articles did not report any methods of quality control methods. The most used quality control methods were back-translation only, and back-translation and expert review. 42% specified at what point the target population was included in the adaption process, and the preference was during pilot testing and focus groups. Regarding translators, 7 articles indicated the tools were translated by the researchers, 10 by independent bilinguals, and 3 utilized a team in the translation process. Conclusion: While cultural relevance and appropriateness were emphasized in these articles, there is limited information reported on what this process entailed. There were no specific or general guidelines reported. More focus should be placed on developing a culturally relevant protocol and related guidelines for the translation and adaptation process of assessment tools.

The onerous granting of the right to build: an alternative form of financing in the popular housing programs of the municipality of Goiânia

The City Statute (Law nº 10.257/2001) established general norms for the elaboration of the Master Plan by the Municipalities, including defining that not only the OODC, but all urban policy instruments defined therein, must follow the general guidelines of urban policy, such as the fair distribution of burdens and benefits, the recovery of government investments that result in the appreciation of urban properties and, in the specific case of Onerous Grants, that part of the amounts collected with their concession are applied in social housing programs. In this sense, the scope of the implementation of the urban instrument of the Onerous Grant of the Right to Build is discussed, based on its criticisms and distortions, in case there is a legal binding expressed in the local legislation of the percentage of collection of its revenues linked to housing programs of social interest.

Design of Structures Subjected to Blast Loads: Analysis and Design Review

When designing structures to withstand explosions, the main goals are to minimize the number and extent of occupant injuries and to reduce the chance of catastrophic damage to structures. Although there is uncertainty in the source, extent, and location of explosions, the assessment of blast loading and structural performance is important when designing blast-resistant structures. This study is a review of the literature on the prediction of blast loads, structural modeling and analysis, and design criteria for structures to resist explosions. The paper provides in one concise document the general guidelines, references, and tools that structural engineers and researchers need to analyze and design structures subjected to blast loading. References on the topics discussed in this work are provided for more detail.

The Association Between Energy Adequacy Level And Physical Activity With Nutri-tional Status In Adolescents At Walisongo High School, Ketanggungan

Growth during adolescence is rapid due to the development of muscle mass and fat tissue as well as hormonal changes that affect the nutritional needs of adolescents. The purpose of this study was to determine how the nutritional status of adolescents and the level of energy adequacy and physical activity relate to each other. This type of research uses a cross-sectional design. The number of samples taken with simple random sampling technique in this study was 152 people. Data collection of energy adequacy level using SQ-FFQ, physical activity data with PAL questionnaire, and nutritional status of respondents obtained from measurements of BW and TB. The results showed that most participants had an adequate level of energy sufficiency (65.1%) according to the Spearman Rank test, physical activity was mostly in the moderate category (63.8%), and the majority had good nutritional status (80.9%). The results of the Spearman Rank test showed that there was a significant correlation between the level of energy adequacy and nutritional status (p value = 0.045) and there was a significant correlation between physical activity and nutritional status (p value = 0.021). The conclusion is that there is a significant correlation between the level of energy adequacy and physical activity with nutritional status in adolescents at Walisongo Ketanggungan High School. It is recommended for the school to collaborate with the health department or local health center to make preventive and promotive efforts related to nutritional status problems through education about General Guidelines for Balanced Nutrition (PUGS).

Mechanical response of 3D printed irregular sutural tessellations with Voronoi tile patterns under tension

The mechanical response of bio-inspired irregular sutural tessellations with Voronoi tile patterns are designed and fabricated via multi-material 3D printing. The effective mechanical properties of the designs were characterized via uni-axial tension mechanical experiments on the 3D printed specimens. Systematic nonlinear finite element simulations are conducted to explore the damage initiation and evolution of the designs. The influences of important design parameters, including tile length aspect ratio R, tile size irregularity Cstd, suture amplitude irregularity Astd, and stiffness ratio between the soft and hard phases, were evaluated. The effective stiffness, Poisson’s ratio, strength, toughness, and failure mechanisms are systematically quantified. The results demonstrate that an optimized level of suture irregularity exists for maximizing the modulus of toughness. The results provide a general design guideline for designing functionally graded two-phase tessellations with high mechanical performance.